Welfare

Sheet Metal Workers' International Association Local Union No.73 Pension Welfare and Annuity Funds
	Table of Contents : Important Contact Information Important Benefit Information Schedule of Benefits Eligibility for Benefits - Bargained Members Your Initial Eligibility if You are a Bargained Member Your Dependents' Eligibility Qualified Medical Child Support Order (QMCSO) Continuation of Eligibility if You are a Bargained Member Termination of Your Eligibility if You are a Bargained Member Termination of Dependent Eligibility for Bargained Members Reinstatement of Eligibility Enrollment Procedures Special Enrollment Certificate of Crediable Coverage Eligibility for Benefits - NON-BARGAINED Members Initial Eligibility for Non-Bargained Members Your Dependents' Eligibility Continuation of Eligibility - Non-Bargained Members Termination of Your Eligibility - Non-Bargained Member Termination of Dependent Eligibility for Non-Bargained Members Reinstatement of Eligibility - Non-Bargained Member Enrollment Procedures Special Enrollment Preexisting Condition Limitation for Non-Bargained Members Employee Contributions - Non-Bargained Employees Certificate of Crediable Coverage Life Events Getting Married Adding a Child Getting Divorced or Legally Separated Child Losing Eligibility Taking A Family and Medical Leave of Absence Taking a Military Leave In the Event of Death When You Stop Working or Retire Continuation of Health Benefits Continuation of Coverage During Family and Medical Leave Continuation of Coverage During Military Leave COBRA Continuation Coverage Comprehensive Major Medical Benefit (Employees and Dependents) Preferred Provider Organization (PPO) Calendar Year Deductible Common Accident Coinsurance Out-of-Pocket Maximum Pre-Admission Authorization Covered Expenses Hospice Benefit Extension of Benefits Wellness Expense Benefit (Employee and Spouse Only) Substance Abuse Employee Assistance Program (EAP) (Employee and Dependent) Optical Benefits (Employees and Dependents) Hearing Aid Benefit (Employees and Dependents) Prescription Drug Benefits (Employees and Dependents) Retail Pharmacy Network Mail Order Prescription Drug Service Prescription Drug Exclusions and Limitations Prescription Drug Benefits Coordination with Medicare Part D Death Benefit (Active Employees Only) Accidental Death and Dismemberment Benefits (Active Employees Only) Weekly Accident and Sickness Disability Benefit General Exclusions and Limitations How to File a Claim Filing Claims Other than Major Medical Claims Workers' Compensation Claims Procedures Claim Filing Period Assignment of Benefits Comprehensive Major Medical Benefit Claims Weekly Accident and Sickness Disability Benefit Claims If your Claim in Denied Appealing the Denial of Your Claim Limitation on Legal Actions Payment of Benefits Misrepresentation or Falsification of Claim and Wrongfully Paid Benefits Coordination of Benefits Determining Which Plan Pays First Information Required for Coordination of Benefits How Medicare Affects Medical Benefits Under the Plan About Medicare Coordination of Your Plan Benefits with Medicare Reimbursement Policies and Procedures Benefits to Which Reimbursement Applies Situations Where Reimbursement Provisions May Apply Reimbursement Procedures Refusal to Cooperate in Reimbursement Claims Important Information About the Plan Statement of Rightw Under the Employee Retirement Income Security Act (ERISA) Your Privacy Rights Under the Plan Definitions Appendix A: Durable Medical Equipment and Supplies
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